Document Type : Original Article


Department of Psychiatry, AIIMS, Raipur, Chhattisgarh, India


BACKGROUND: The lack of fundamental knowledge and awareness about the biological process of
reproduction is low worldwide but has reportedly higher incidence rates in under‑developed countries.
Infertility can have a tremendous effect on a woman’s psychological and social well‑being, pushing
her toward mental stress, anxiety, depression self‑blame, self‑isolation, feeling of worthlessness,
and lack of interest in life. The present study was conducted to determine the level of knowledge and
awareness regarding factors affecting fertility and also to ascertain the emotional status of females
visiting the Obstetrics and Gynecology out‑patient department for fertility assistance.
MATERIALS AND METHODS: A cross‑sectional study was performed by using a questionnaire
which had two parts; the first part had questions about awareness and knowledge of the subject
of infertility, and the second part had 12 questions that assessed the psychological and emotional
status of the participants, and it also explored prevailing myths about infertility based on a validated
RESULTS: There was a significant difference in mean knowledge score; those who were more
educated had better knowledge of various aspects of infertility. The overall adequacy for knowledge
and awareness revealed that only 62 (47.7%) of the participants had adequate knowledge (score >6)
regarding female infertility. The mean score for knowledge among all the respondents was 6.61 ± 1.48.
The overall emotional and psychological score suggested that 30 (23%) of the respondents were
disturbed because of stress because of infertility.
CONCLUSION: Infertility can have a serious impact on the psychological well‑being of females,
and social pressure and stigma associated with childlessness can further worsen the physical and
emotional well‑being of couples, which needs to be addressed before starting treatment of infertility
for a better response to treatment. The limited knowledge and prevailing mis‑conceptions regarding
infertility need to be sincerely dealt with to complement the medical treatment of infertility.


1. Vander Borght M, Wyns C. Fertility and infertility: Definition
and epidemiology. Clin Biochem 2018;62:2-10. doi: 10.1016/j.
clinbiochem. 2018.03.012. Epub 2018 Mar 16. PMID: 29555319.
2. KamelRM. Management of the infertile couple: An evidence‑based
protocol. Reprod Biol Endocrinol 2010;8:1‑7.
3. Walker MH, Tobler KJ. Female Infertility. In: StatPearls [Internet].
Treasure Island (FL): StatPearls Publishing; 2022. Available from: [Last
updated on 2022 May 26].
4. World Population Prospects: The 2017 Revision | Multimedia
Library ‑ UnitedNations Department of Economic and Social Affairs.
Available from:
html. [Last accessed on 2018 Jan 08].
5. Kshrisagar SP, Shirsath AS, Navale K. A cross‑sectional study of
fertile period awareness, knowledge, attitudes and practice in
infertile couples seeking fertility assistance. India Int J Reprod
Contracept 2018;7:3744‑7.
6. Van Voorhis BJ. In vitro fertilization. N Engl J Med 2007;356:379‑86.
7. Bunting L, Tsibulsky I, Boivin J. Fertility knowledge and beliefs
about fertility treatment: Findings from the international fertility
decision‑making study. Hum Reprod Oxf Engl 2013;28:385–97.
8. DanilukJC, KoertE. The other side of the fertility coin: Acomparison
of childless men’s and women’s knowledge of fertility and assisted
reproductive technology. Fertil Steril 2013;99:839–46.
9. Bunting L, Boivin J. Knowledge about infertility risk factors,
fertility myths and illusory benefits of healthy habits in young
people. Human Reprod 2008;23:1858‑64.
10. Ali S, Sophie R, Imam AM, Khan FI, Ali SF, Shaikh A, et al.
Knowledge, perceptions and myths regarding infertility among
selected adult population in Pakistan: A cross‑sectional study.
BMC Public Health 2011;11:760.
11. Anderson K, Nisenblat V, Norman R. Lifestyle factors in people
seeking infertility treatment‑A review. Aust N Z J Obstet Gynaecol
12. Homan GF, Davies M, Norman R. The impact of lifestyle factors
on reproductive performance in the general population and
those undergoing infertility treatment: A review. Human Reprod
Update 2007;13:209‑23.
13. Güngör I, Rathfisch G, Kızılkaya Beji N, Yarar M, Karamanoğlu F.
Risk‑taking behaviours and beliefs about fertility in university
students. J Clin Nurs 2013;22:3418‑27.
14. Abolfotouh MA, Alabdrabalnabi AA, Albacker RB,
Al‑Jughaiman UA, Hassan SN. Knowledge, attitude, and practices
of infertility among Saudi couples. Int J Gen Med 2013;6:563‑73.
15. Sadeu JC, Hughes CL, Agarwal S, Foster WG. Alcohol, drugs,
caffeine, tobacco, and environmental contaminant exposure.
Reproductive health consequences and clinical implications. Crit
Rev Toxicol 2010;40:633‑52.
16. Millheiser L, Helmer A, Quintero R, Westphal L, Milki A, Lathi R.
Is infertility a risk factor for female sexual dysfunction? A case–
control study. Fertil Steril 2010;94:2022–5.
17. Tao P, Coates R, Maycock B. Investigating marital relationship in
infertility: A systematic review of quantitative studies. J Reprod
Infertil 2012;13:71–80.
18. Baranwal A, Kunwar N, Tripathy S. Causes of increasing rate of
female infertility in India. Int J Sci Res 2015;4:237–8.
19. Singh D. Psychiatric morbidity in infertile women undergoing
treatment at an IVF centre. Int J Contemp Med Res 2018;5:G1‑5.
20. SuleR, Gupte S. Study of psychiatric morbidity in infertile women.
MVP J Med Sci 2015;2:30‑3.
21. Kocełak P, Chudek J, Naworska B, Bąk‑Sosnowska M, Kotlarz B,
Mazurek M, et al. Psychological disturbances and quality of
life in obese and infertile women and men. Int J Endocrinol
22. ESHRE Task Force on Ethics and Law, Pennings G, de Wert G,
ShenfieldF, Cohen J, TarlatzisB, et al. Providing infertility treatment
in resource‑poor countries. Hum Reprod 2009;24:1008–11.
23. Singh T, Sharma S, Nagesh S. Socio‑economic status scales
updated for 2017. Int J Res Med Sci 2017;5:3264‑7.
24. BretherickKL, FairbrotherN, AvilaL, HarbordSHA, RobinsonWP.
Fertility and aging: Do reproductive‑aged Canadian women know
what they need to know? Fertil Steril 2010;93:2162–8.
25. Kudesia R, Chernyak E, McAvey B. Low fertility awareness in
United States reproductive‑aged women and medical trainees:
Creation and validation of the Fertility & Infertility Treatment
Knowledge Score (FIT‑KS). Fertil Steril 2017;108:711–7.
26. Hammarberg K, Setter T, Norman RJ, Holden CA, Michelmore J,
Johnson L. Knowledge about factors that influence fertility among
Australians of reproductive age: A population‑based survey Fertil
Steril 2013;99:502‑7.
27. Siyez DM, Seymenler S, Esen E, Siyez E, Kağnıcı Y, Baran B, et al.
Investigating knowledge levels of university students about
infertility. Turk J Urol 2018;44:153‑61.
28. Rouchou B, Forde MS. Infertility knowledge, attitudes and beliefs
of college students in Grenada. Sci J Public Health 2015;3:353‑60.
29. Hampton KD, Mazza D, Newton JM. Fertility‑awareness
knowledge, attitudes, and practices of women seeking fertility
assistance. J Adv Nurs 2013;69:1076–84.
30. García D, Vassena R, Trullenque M, Rodríguez A, Vernaeve V.
Fertility knowledge and awareness in oocyte donors in Spain.
Patient Educ Couns 2015;98:96–101.
31. Mahey R, Gupta M, Kandpal S, Malhotra N, Vanamail P, Singh N,
et al. Fertility awareness and knowledge among Indian women
attending an infertility clinic: A cross-sectional study. BMC
Womens Health 2018;18:177. doi: 10.1186/s12905-018-0669-y.
PMID: 30373587
32. Gueye A, Speizer IS, Corroon M, Okigbo CC. Belief in family
planning myths at the individual and community levels and
modern contraceptive use in urban Africa. Int Perspect Sex Reprod
Health 2015;41:191–9.
33. Daar AS, Merali Z. Infertility and social suffering: The case of ART
in developing countries. In: VayenaE, Rowe PJ, Griffin PD, editors.
Current Practices and Controversies in Assisted Reproduction.
Geneva, Switzerland: World Health Organization; 2002. p. 15–21.
34. WischmannT. Psychosocial aspects of infertile couples. Psychosocial
Gynakol Geburts Med Gynakol Endokrinol 2008;4:194‑209.
35. Hasanpoor‑Azghdy SB, Simbar M, Vedadhir A. The
emotional‑psychological consequences of infertility among
infertile women seeking treatment: Results of a qualitative study,
Iran J Reprod Med 2014;12:131‑8.
36. Franco JG Jr, Razera Baruffi RL, Mauri AL, Petersen CG, Felipe V,
Garbellini E. Psychological evaluation test for infertile couples.
J Assist Reprod Genet 2002;19:269‑73.
37. Sujindra E, Bupathy A, Praveena R, Sivasankari T. Psychological
evaluation of infertile couples: Results of a questionnaire survey.
Fertil Sci Res 2015;2:34‑6.
38. Poddar S, Sanyal N, Mukherjee U. Psychological profile of
women with infertility: A comparative study. Ind Psychiatry J
39. Javadzade SH, Sharifirad G, Radjati F, Mostafavi F, Reisi M,
Hasanzade A. Relationship between health literacy, health status,
and healthy behaviors among older adults in Isfahan, Iran. J Edu
Health Promot 2012;1:31.
40. Shooshtari S, Abedi MR, Bahrami M, Samouei R. Empowerment
of women and mental health improvement with a preventive
approach. J Educ Health Promot 2018;7:31.